The Study Of Regional Homogeneity And Voxel-mirrored Homotopic Connectivity Of Minimal Hepatic Encephalopathy Disease At Resting-state FMRI

Objective: to investigate the abnormal changes of regional brain activity in patients with minimal hepatic encephalopathy(MHE)and the changes of functional connections and synchronization of neural activities between symmetrical alleles in bilateral cerebral hemispheres by resting brain function MRI technique.It provides a reliable imaging basis for exploring the pathophysiological mechanism of the occurrence and development of MHE.Methods: based on the results of corrected neuropsychological test,20 patients with MHE(13 males and 7 females,mean age 51.6 ±4.7 years)and 20 healthy controls(14 males and 6 females)were enrolled in this study.The mean age was 48.2±5.5 years).Siemens 3.0T MR scanning was performed in both groups,and structural imaging(T1-mprage)and blood oxygen level dependent-functional magnetic resonance imaging(BOLD-fMRI)images were collected.The results of MR structure and function images of all subjects were pre processed with SPM 8.0 software,DPASF 4.3 software and REST 1.8 software that based on Matlab2013 b software package for regional homogeneity(ReHo)and Voxel-mirrored homotopic connectivity(VMHC)were used to analyze and compare the functional differences of regional brain regions and the abnormal changes of neural activity synchronization between bilateral cerebral hemispheric symmetrical brain regions in the resting state between the two groups.Results the results were presented by standardized ReHo statistical difference diagram and VMHC statistical difference diagram,respectively.Results: 1.Statistical analysis showed that there was no significant difference in age and education years between MHE group and HC group(P>0.05).2.The statistical analysis of ReHo method found that compared with HC group,the brain area with reduced ReHo value in MHE group occurred in bilateral frontallobe(main including superior frontal gyrus and middle frontal gyrus)(Voxel level,P<0.05,FDR correction);3.The statistical analysis of VMHC method found that compared with HC group,the brain area with reduced VMHC value in MHE group included superior frontal gyrus,medial frontal gyrus,middle temporal crest,lingual gyrus,anterior cingulate gyrus,cerebellar hemisphere,tegmental and the pons(Voxel level,P<0.05,FDR correction).Conclusion: 1.At rest,the ReHo value of the frontal lobe of MHE patients is abnormal,suggesting that the consistency of neuronal activity in the frontal lobe is reduced,and this change suggests that the brain is associated with clinical manifestations of cognitive dysfunction;2.MHE patients with superior frontal gyrus,medial frontal gyrus,middle temporal crest,lingual gyrus,anterior cingulate gyrus,cerebellar hemisphere and tegmental and the pons,may be due to bilateral MHE patients Impaired integrity of the connections between the cerebral hemispheres leads to decreased neurological synchrony in multiple brain regions of the bilateral cerebral hemisphere,these changes may be the pathological basis of impairment of cognitive,motor and emotional regulation in patients with MHE.3.ReHo and VMHC analysis methods are simple,effective and reproducible.They can provide theoretical basis for the interpretation of MHE clinical manifestations,research pathophysiological changes and exploration of pathogenesis.